Investigation of the Function of Modified Shock Index in the Disease Assessment of Emergency Cases_West China Medical Journal

Authors：

 XULing-jie ¹ , XUJun ² ,  WANGZhong ³

1. Emergency Department, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Emergency Department, Peking Union Medical College Hospital, Beijing 100032, P. R. China;
3. Beijing Tsinghua Changgung Hospital, Beijing 102218, P. R. China;

Corresponding author：

WANGZhong, Email: wangzhong523@vip.163.com

Keywords：

Vital sign; Mean arterial pressure; Modified shock index; Emergency triage; Condition judgment

DOI：

10.7507/1002-0179.20150296

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Objective To research on the correlation between modified shock index (MSI), traditional vital sign assessment indexes and the proportion of patients entering resuscitation room through emergency triage, and to discuss its significance and advantages for emergency triage. Method A total of 22 153 emergency patients between January 1 and May 31, 2009 were retrospectively analyzed. We counted the shock index (SI), mean arterial pressure (MAP), MSI, and evaluated the reference range of MSI, based on which, the patients were divided into groups, and the proportion of patients entering resuscitation room in each group was compared. Based on pulse, systolic blood pressure (SBP), SI, MAP and MSI, the patients were again grouped for comparing the proportion of patients entering resuscitation room, and the positive predictive value, negative predictive value, and odds ratio (OR) were also analyzed. Results Reference value of MSI ranged from 0.34 to 1.70 times/(min·mm Hg) (1 mm Hg=0.133 kPa). Positive predictive values:MSI (16.239%) >MAP (6.115%) >pulse (5.746%) >SBP (5.321%) >SI (3.689%). The negative predictive values were all at high levels and similar with each other. OR:MSI (6.138) >MAP (2.498) >pulse (2.431) >SBP (2.117) >SI (1.361). Conclusions Pulse, SBP, SI, MAP, and MSI are correlated with the proportion of patients entering resuscitation room, and can be regarded as guide for emergency triage, among which MSI may be superior to all other indexes.

Citation： XULing-jie, XUJun, WANGZhong. Investigation of the Function of Modified Shock Index in the Disease Assessment of Emergency Cases. West China Medical Journal, 2015, 30(6): 1031-1034. doi: 10.7507/1002-0179.20150296 Copy

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11.	麦泉云, 赵开亮, 张凤莲, 等. 改良早期预警评分结合心电图、休克指数、血氧饱和度对评估急诊患者病情危重程度的价值[J]. 广西医学, 2012, 34(10):1305-1308.
12.	Vassallo J, Horne S, Ball S, et al. Usefulness of the shock index as a secondary triage tool[J]. J R Army Med Corps, 2015, 161(1):53-57.
13.	项涛. 休克指数对急性危重病人预后的判断价值[J]. 四川省卫生管理干部学院学报, 2006, 25(3):208.
14.	温勇伟, 邬真力, 吴雷, 等. 超声心动图与休克指数在评价肺栓塞预后中的意义[J]. 广东医学, 2009, 30(4):578-580.
15.	余愿, 付朝晖, 徐梦, 等. 休克指数对感染性休克患者预后的预测价值[J]. 临床急诊杂志, 2014, 15(9):535-537.
16.	Mccall SJ, Musgrave SD, Potter JF, et al. The shock index predicts acute mortality outcomes in stroke[J]. Int J Cardiol, 2015, 182:523-527.
17.	陈炜, 臧学峰, 牛素平, 等. 监测液体复苏前后血流动力学参数对脓毒性休克短期预后的早期预测价值[J]. 中华危重病急救医学, 2015, 27(1):43-47.
18.	King RW, Plewa MC, Buderer NM, et al. Shock index as a marker for significant injury in trauma patients[J]. Acad Emerg Med, 1996, 3(11):1041-1045.

1. 赵丽新. 急诊分诊快速评分对老年患者病情评价[J]. 中国医药导报, 2011, 8(9):118-119.
2. 齐志伟, 刘业成, 徐军, 等. 急诊患者死亡危险因素分析[J]. 中国全科医学, 2011, 14(14):1608-1609.
3. 谭慧琼, 朱俊, 宋有城, 等. 急性左心衰竭并休克病人动脉内血压监测指导血管活性药物应用[J]. 中国循环杂志, 2001, 16(4):265-266.
4. 张光华. 特利加压素与去甲肾上腺素对≥80岁感染性休克患者平均动脉压及休克指数的影响[J]. 临床和实验医学杂志, 2014, 13(16):1346-1348, 1349.
5. D'aragon F, Belley-Cote EP, Meade MO, et al. Blood pressure targets for vasopressor therapy:a systematic review[J]. Shock, 2015, 43(6):530-539.
6. Guyette FX, Meier EN, Newgard C, et al. A comparison of prehospital lactate and systolic blood pressure for predicting the need for resuscitative care in trauma transported by ground[J].J Trauma Acute Care Surg, 2015, 78(3):600-606.
7. Cannon CM, Braxton CC, Kling-Smith K, et al. Utility of the shock index in predicting mortality in traumatically injured patients[J]. J Trauma, 2009, 67(6):1426-1430.
8. Birkhahn RH, Gaeta TJ, Van Deusen SK, et al. The ability of traditional vital signs and shock index to identify ruptured ectopic pregnancy[J]. Am J Obstet Gynecol, 2003, 189(5):1293-1296.
9. Birkhahn RH, Gaeta TJ, Terry D, et al. Shock index in diagnosing early acute hypovolemia[J]. Am J Emerg Med, 2005, 23(3):323-326.
10. Jones AE, Trzeciak S, Kline JA. The sequential organ failure assessment score for predicting outcome in patients with severe sepsis and evidence of hypoperfusion at the time of emergency department presentation[J]. Crit Care Med, 2009, 37(5):1649-1654.
11. 麦泉云, 赵开亮, 张凤莲, 等. 改良早期预警评分结合心电图、休克指数、血氧饱和度对评估急诊患者病情危重程度的价值[J]. 广西医学, 2012, 34(10):1305-1308.
12. Vassallo J, Horne S, Ball S, et al. Usefulness of the shock index as a secondary triage tool[J]. J R Army Med Corps, 2015, 161(1):53-57.
13. 项涛. 休克指数对急性危重病人预后的判断价值[J]. 四川省卫生管理干部学院学报, 2006, 25(3):208.
14. 温勇伟, 邬真力, 吴雷, 等. 超声心动图与休克指数在评价肺栓塞预后中的意义[J]. 广东医学, 2009, 30(4):578-580.
15. 余愿, 付朝晖, 徐梦, 等. 休克指数对感染性休克患者预后的预测价值[J]. 临床急诊杂志, 2014, 15(9):535-537.
16. Mccall SJ, Musgrave SD, Potter JF, et al. The shock index predicts acute mortality outcomes in stroke[J]. Int J Cardiol, 2015, 182:523-527.
17. 陈炜, 臧学峰, 牛素平, 等. 监测液体复苏前后血流动力学参数对脓毒性休克短期预后的早期预测价值[J]. 中华危重病急救医学, 2015, 27(1):43-47.
18. King RW, Plewa MC, Buderer NM, et al. Shock index as a marker for significant injury in trauma patients[J]. Acad Emerg Med, 1996, 3(11):1041-1045.

West China Medical Journal

Investigation of the Function of Modified Shock Index in the Disease Assessment of Emergency Cases

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